BOZEMAN — Rural Montana, with a population that’s both short on physicians and graying faster than the rest of the country, needs health care reform, Democratic Sen. Max Baucus said Thursday.

Speaking to farmers and economists at a rural health care conference, Baucus said few groups would benefit more from healthcare reform than the uninsured and the underserved, two groups rural Montana has in abundance.

“There’s a lot here and I think this will put Montana farmers and ranchers in better shape,” Baucus said. “Life is choices. I think we need to do this the best way we can. If we do nothing, this is going to get much, much worse.

Baucus has been instrumental in shepherding healthcare reform bills through the Senate, including his own plan to, among other things, ban insurance companies from denying coverage for preexisting conditions and allow people to form healthcare cooperatives as a theoretically cheaper competitor to private health insurance. One of a few health care bills churning through the Senate, Baucus’ plan was priced just under $1 trillion, considered the tipping point of affordability. Others are more expensive, but include public health insurance options, which the Montana Democrat’s doesn’t.

Rural agriculture representatives were split on supporting federal healthcare measures.

“Our members do think there needs to be reform, but they want the option to not have coverage,” said Nancy Schlepp, of the politically right-leaning Montana Farm Bureau Federation. “They want to buy insurance across state lines and they would like to see tort reform.”

Baucus and others lawmaker have stated repeatedly that reform cannot happen unless health insurance is mandatory for most people. The physician’s lobby, hospitals and pharmaceutical companies who now support healthcare reform, but opposed past efforts, are on board partly because they’re convinced mandatory coverage will drive up patient volume high enough to compensate for the lower medical payments, sought through reform.

Chris Christiaens, lobbyist for the left-leaning Montana Farmers Union, said without reform physicians will become scarcer.

“Many physicians will go to Kalispell or the Western Montana area,” Christiaens said. “Those of use who live east of the mountains are always in the process of looking for physicians to practice.”

The average Montana farmer is 57, Christieans said, an age when hypertension, diabetes and heart problems show up in people who previously had few medical problems. He said he knows farmers who, faced with high bills for fertilizer and fuel are canceling their insurance to stay in business.

Baucus said increasing the number of general practitioners is part of the reform plan he advocates. He said he’d like to increase the number physicians trained in Billings by manipulating Medicare spending on training. Medicare is a key funding source for medical training, Baucus said.

Montana healthcare is also part of the solution, Baucus said. Medical care in the Northern Plains states is 29 percent cheaper than it is in cities and Sun Belt states. If that component of Montana healthcare can be applied broadly, costs should drop $800 billion, he said.

Contact Tom Lutey at tlutey@billingsgazette.com or 657-1288.